PFLCP内固定治疗老年外侧壁危险型股骨粗隆间骨折的疗效观察

Clinical effect of proximal femur locking compression plate for interchanteric femoral fractures with lateral wall risk in elderly

目的评价股骨近端锁定加压钢板（PFLCP）内固定治疗老年外侧壁危险型股骨粗隆间骨折的临床疗效。方法回顾性分析自2009—06—2013—10采用PFLCP内固定治疗72例老年外侧壁危险型股骨粗隆间骨折，术后依据Harris评分评价患者髋关节功能恢复情况。结果所有患者均获得随访12～22个月，平均14．3个月。骨折均愈合，愈合时间13-21周，平均17．1周。术后1年疗效依据Harris评分评定：优54例，良10例，可3例，差5例，优良率88．9％。出现髋内翻畸形2例，髋外展无力l例，大粗隆顶端骨块上移1例。无股骨头切割、内固定断裂及骨折不愈合等并发症发生。结论PFLCP治疗老年外侧壁危险型股骨粗隆间骨折符合生物力学特性，骨折愈合率高，功能恢复佳，并发症少，是治疗此类骨折安全有效的方法。

Objective To evaluate clinical effect of proximal femur locking compression plate （PFLCP） for intertrochanteric femoral fractures with risk external wall in old patients. Methods From June 2009 to October 2013, 72 old patients with intertrochanteric femoral fractures with lateral wall risk were treated with proximal femur locking compression plate. During follow-up, hip functions were assessed according to the Harris hip scoring system. Results The average follow-up duration was 14.3 months with a range of 12-22 months. All cases showed well fracture healing. The time of fracture healing was 13 to 21 weeks, with an average of 17.1 weeks. According to the Harris hip scoring system, hip functions were excellent in 54, good in 10, fair in 3 and poor in 5. The excellent and good rate was 88.9%. Two cases had hip varus deformity, 1 case weakness of hip abduction, and 1 case displacement on the top of greater trochanter. No major complications of cut-out, breakage of the implant and non-union occurred. Conclusion PFLCP for femoral intertrochanteric fractures with lateral wall risk in old patients, conforming to biomechanics, has high rate of fracture healing and good functional recovery of hip joint, and can reduce the incidence of complications. It is a good method of surgical treatment for femoral intertrochanteric fractures especially in the case with lateral wall risk.